Thoughts in the Time of Coronavirus

It is our civic duty to cooperate with measures being taken to contain the spread of this disease and to build solidarity, writes Prema Devaraj.

We are in the midst of a global coronavirus disease (Covid-19) pandemic. 

We are checking our mobile phones frequently to find out the latest statistics on new cases detected, ICU cases, recoveries and deaths.

Some of us worry we might follow the trend in Italy and Spain, that things might worsen, overwhelm our public healthcare system and push up the death toll. That would be catastrophic.

So what are we doing? Different countries have taken different approaches. Malaysia seems to be adopting a suppression strategy, by breaking the transmission of the virus and hence “flattening the curve”, ie staggering the number of new cases over a longer period, so that people have better access to care. 

This method is similar to that used in Wuhan, Singapore, Hong Kong and South Korea, ie identification of cases, contact tracing, testing of samples and the quarantining of confirmed and suspected cases, including, social distancing and self-isolation.

While the suppression strategy may not be the final solution to the problem, it, if followed through effectively, could ultimately result in:

• fewer total cases of coronavirus
• immediate relief for the healthcare system and those running it
• reduction in the death rate
• reduction in collateral damage (ie fewer people dying from other ailments arising from inaccessibility to prompt treatment due to overwhelmed hospitals)
• the ability of infected, isolated and quarantined healthcare workers to recover and get back to work

Mass testing would help identify those who are Covid-19 positive so that they can be quarantined, thereby preventing transmission to others.

An important part of the suppression strategy in Malaysia has been the enforcement of a movement control order. The two-week order from 18 March to 31 March has now been extended to 14 April. It took some time for people to understand how Covid-19 is transmitted, why social distancing is necessary and what a movement control order means.

Huge efforts have been made, with public service announcements all over the media. Many were initially confused about what they could do and where they could go, but after a week, the compliance rate is now about 95%.

Managing the crisis in Malaysia is a huge challenge. The number of confirmed cases could run into the thousands if efforts to suppress the pandemic are not taken. The logistics of treatment, equipment, testing and quarantining of people requires funds.

The new Perikatan Nasional (PN) government has allocated RM600m to the Ministry of Health to help in handling Covid-19 (eg buying equipment) and to appoint 2,000 new contract staff especially nurses. The corporate sector is chipping in to raise funds for equipment and to replenish medical supplies.

But much more is needed. More serious thought must be given to how the different healthcare providers – private clinics and private hospitals – can help reduce the burden on public hospitals.

Then comes the huge economic impact on people when a movement control order is enforced, ie businesses shut down and people staying away from work.

The PN government has come up with financial assistance for the people including:

• RM600 per month for six months for those who have been given notice to take unpaid leave from 1 March
• RM200 Bantuan Sara Hidup payment has been brought forward to March with an additional one-off payment of RM100 to come later
• a special Covid-19 Fund to cover those placed under 14-day home surveillance and Covid-19 patients treated in hospital. This provides those without a fixed income or salary RM100 daily for the duration of the quarantine
• a stimulus package which includes restructuring and rescheduling of loans, assisting the cashflow of small and medium-sized enterprises, tax exemptions and deferments  
• RM130m to be distributed equally to all state governments to handle the crisis in each state

While most initiatives were welcomed, the one that allowed EPF holders below 55 to withdraw up to RM500 for 12 months starting 1 April drew strong protest from various quarters. The main concern is that people will use up their own savings and lose out on annual and compounded dividends in the long term. It will also deplete their long-term retirement savings.

While it can be argued this move will provide some EPF contributors access to cash, some 2.8 million other Malaysians do not have enough savings in their EPF accounts to benefit from this measure. Some have urged the government to use its own reserves to help the people or to provide interest-free loans instead of asking people to deplete their old-age savings.

It remains unclear how these measures will be administered and monitored for effectiveness.

That said, many others will not be able to benefit from the range of financial assistance being offered. These people include casual contract labourers, daily paid wage earners eg those working in coffee shops, the part-timers, the self-employed, migrant workers who may not be paid on days they do not work, the homeless and the refugees.

What will become of them during this movement control period, which has now been extended to four weeks? Social protection must be for all. It cannot be a question of “we only have funds for locals”. If we want to curb the infections, we need to treat everyone equally and provide support, free testing and treatment to all.

Hopefully, the offices of the various elected representatives and the district and village committees will be able to identify these vulnerable groups and provide access for them to seek help and support.

Let us also remember the gender perspective when coming up with strategies to respond to Covid-19. Groups have expressed concerned over a possible spike in domestic violence and child abuse cases as has been seen in quarantine situations elsewhere. Information on such matters and help lines have to be clearly advertised and kept open so that victims can seek help and support.

According to a World Health Organization Report on Addressing Sex and Gender in Epidemic Prone Infectious Diseases, typical gender roles can influence where men and women spend their time, the infectious agents they come into contact with, and the nature of exposure, the frequency and its intensity.

This means the roles that women play as healthcare professionals, especially nurses, and as caregivers in their homes may place them at greater risk of infection. What happens to their families when this happens?

With schools and kindergartens are closed under the movement control order, women, especially single mothers, will have to juggle earning and caring for children at home. The existing structure of the workforce will see more women who are paid less and often in part-time work (thus having more flexibility) taking on unpaid caregiving work.

The level of stress will rise especially when finances become an issue. Hopefully, the various forms of government assistance will be of some help to the many women facing such issues.

As the battle continues, we owe a debt of gratitude to the medical personnel dealing with patients. They are being tested to their limits at many levels. Worryingly, some of these medical personnel are already down with Covid-19. And so, we pray for their resilience and recovery.

We are also grateful to the other front liners: those keeping essential services open, food delivery personnel, bank and courier service staff, workers at grocery shops and food takeaway outlets, cleaners, local council workers, rubbish collectors, etc.

Then there are those in civil society including faith-based groups who have launched initiatives to reach out and assist vulnerable groups and individuals in the community.

Let us not forget the police, army and local council enforcement agency personnel who are all involved in getting the public to abide by the movement control restrictions.

It is frustrating to see people who:

• ignore movement control and social distancing efforts
• do not take precautions when coughing or sneezing
• think machoism, bravado or faith in God will keep the virus away
• are not honest about their contacts with Covid-19 positive people
• refuse to come in for testing

This kind of ignorance, arrogance or fear places them and others at risk.

Then there are the hoarders, who deprive others of vital supplies (eg groceries and face masks) and those who spread false information and fears regarding Covid-19.

All these people just hinder the efforts being taken to suppress the pandemic

The new Perikatan Nasional government – we are reminded not to call it a “backdoor’ government or an “illegitimate” government because, technically, no law was breached and its formation was constitutional – is now in charge.

For now, we have to put aside our disagreement with this government and our dismay at how it was formed. We have no choice but to work together to help the country through this pandemic.

We can only hope for some level of competency in PN – although the new health minister’s advice on national television about drinking warm water to kill the virus has left many bewildered! Luckily for the country, the director general of health is doing a good job.

Our health and our lives depend on how we reach out to each other and take care of each other, irrespective of our social, ethnic or religious backgrounds – because we are all connected as human beings. The challenge is in building such solidarity of support and assistance while managing the pandemic.

It is our civic duty to cooperate with measures being taken to suppress and contain the spread of this disease so the nation can manage the situation better and stand a better chance of recovery. Let’s all do our part for the country.

For those not involved in front-line work, please just stay at home and help save lives. And while doing that, frequently wash your hands with soap and water and think of creative and effective ways of being supportive and kind to one another.

Stay safe!

The views expressed in Aliran's media statements and the NGO statements we have endorsed reflect Aliran's official stand. Views and opinions expressed in other pieces published here do not necessarily reflect Aliran's official position.

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